Breathlessness

When to get urgent help

Call 999 if breathing is severely difficult, you cannot get words out, your chest feels tight or heavy, your lips or skin turn blue, grey or very pale, or you become suddenly confused. Do not drive yourself to A&E.

Contact NHS 111 for new or worsening breathing difficulty, particularly with coughing blood, one-sided leg pain or swelling, or palpitations. Do not wait for a routine clinic appointment.

What is breathlessness?

Breathlessness is an uncomfortable awareness of breathing. Getting out of breath with strenuous exercise can be normal; a new change or difficulty with usual activities needs assessment. Lung or heart conditions, anaemia, smoking, reduced fitness, excess weight and anxiety can contribute. More than one cause may be present.

How is it assessed?

We first assess urgency, then ask when symptoms started, what brings them on, how they affect activity and whether lying flat makes them worse. We review medicines, previous heart or lung problems and associated symptoms such as cough, wheeze or swelling.

Examination and oxygen measurements guide initial tests, which may include blood tests, an ECG, chest X-ray and spirometry. FeNO can help assess airway inflammation. When heart failure is suspected, an NT-proBNP blood test and echocardiogram may be appropriate.

Further lung or heart investigations depend on these findings. Not everyone needs every test, and several conditions can contribute. We explain the likely causes, agree treatment and review progress. Persistent unexplained symptoms need reassessment.

Read about lung function tests and other investigations.

How is it treated?

Treatment depends on the cause. Once this has been assessed, support may include treatment for a lung or heart condition, stopping smoking, suitable physical activity and rehabilitation. Breathing control, pacing and supported positions can help some people manage ongoing breathlessness. These approaches do not replace urgent assessment of new or worsening symptoms.

Arrange an assessment

Bring your medication list and any previous test results. Our main locations include The Wellington Hospital North Building, Circus Road, and The Clementine Churchill Hospital.

Routine appointment contacts | Clinic locations

Sources and further information

NHS: shortness of breath and urgent advice

Asthma + Lung UK: understanding breathlessness

NHS England: adult breathlessness assessment pathway

General information for adults; investigation and treatment are tailored to you.